Attitudes and barriers toward video visits in surgical care: Insights from a nationwide survey among surgeons

Ashwin J Kulkarni; Anagha B Thiagarajan; Ted A Skolarus; Sarah L Krein; Chad Ellimoottil

doi:10.1016/j.surg.2024.03.033

Attitudes and barriers toward video visits in surgical care: Insights from a nationwide survey among surgeons

Surgery. 2024 May 10:S0039-6060(24)00198-3. doi: 10.1016/j.surg.2024.03.033. Online ahead of print.

Authors

Ashwin J Kulkarni¹, Anagha B Thiagarajan², Ted A Skolarus³, Sarah L Krein⁴, Chad Ellimoottil⁵

Affiliations

¹ Department of Urology, University of Michigan, Ann Arbor, MI; University of Michigan Medical School, Ann Arbor, MI; Institute for Healthcare Policy and Innovation, Ann Arbor, MI. Electronic address: ashkulk@med.umich.edu.
² Helen Diller Family Comprehensive Cancer Center at UCSF, San Francisco, CA; Institute for Healthcare Policy and Innovation, Ann Arbor, MI.
³ Department of Surgery, Section of Urology, University of Chicago, IL.
⁴ University of Michigan Medical School, Ann Arbor, MI; Institute for Healthcare Policy and Innovation, Ann Arbor, MI; Department of Veterans Affairs, Ann Arbor Healthcare System, MI.
⁵ Department of Urology, University of Michigan, Ann Arbor, MI; Institute for Healthcare Policy and Innovation, Ann Arbor, MI. Electronic address: https://twitter.com/chadellimoottil.

PMID: 38734503
DOI: 10.1016/j.surg.2024.03.033

Abstract

Background: Surgeons rapidly adopted video visits during the COVID-19 pandemic. However, video visit use among surgeons has significantly declined, pointing to the need to better understand current attitudes and barriers to their use in surgical care.

Methods: From August 2022 to March 2023, a nationwide survey was conducted among practicing surgeons in 6 specialties. The survey included multiple-choice and free-response questions based on an implementation determinants framework, covering demographics, provider, patient, and organizational factors.

Results: A total of 170 surgeons responded (24% response rate). Overall, 67% of surgeons said their practice lacked motivation for video visit implementation. Additionally, 69% disagreed with using video visits as the sole means for preoperative surgical consultation, even with relevant medical history, labs, and imaging. Nearly 43% cited the need for a physical examination, whereas 58% of surgeons said video visits carried a greater malpractice risk than in-person visits. Other barriers included technological limitations, billing, and care quality concerns. Nevertheless, 41% agreed that video visits could improve outcomes for some patients, and 60% expressed openness to using video visits exclusively for postoperative consultations in uncomplicated surgeries.

Conclusion: Surgeons recognize the potential benefits of video visits for certain patients. However, perceived barriers include the need for a physical examination, technological limitations, care quality concerns, and malpractice risks.